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Responses to Inquiries #2 - As received April 9, 10, and 11 2012 COB

April 9, 2012

Inquiry #1The University of Illinois Department of Psychiatry intends to respond ONLY to the CHIPs portion of the RFI. In completing the application for the CHIPs portion ONLY please address the following questions:

Section VI: We intend to respond ONLY to the CHIPs portion of the RFI. In completing this section and all subsequent attachments do we only provide information as it pertains to our inpatient services or include information that would include the ED, inpatient and outpatient.

Attachment A: Do we only provided information as it pertains to our inpatient and emergency room services.

Attachment B: Does this apply to CHIPs ONLY applications?

Attachment C: Which program code do we use for inpatient psychiatric services? Do we list services in ED if the ED will only be used as an entry point and assessment for inpatient admission.

Attachment D: Do we only provided information as it pertains to our inpatient and emergency room services.
One additional question. What is the response turnaround time from DMH and will you be responding to individual questions via e-mail?
Attachment A: Do we use the overall number of staff as the denominator in describing the specific staffing characterists?
Do the below two questions on Attachment A pertain to CHIPs portion or community health providers.

List of languages spoken by direct service staff including number of staff by credential who speak each language.

List of ethnic groups in which the agency has cultural competence including number of staff by credential with the demonstrated competence for each ethnic group.

DMH RESPONSE:Section VI: We intend to respond ONLY to the CHIPs portion of the RFI. In completing this section and all subsequent attachments do we only provide information as it pertains to our inpatient services or include information that would include the ED, inpatient and outpatient. You need to complete Section VI attachments for each and any specific programs you are proposing to us for funding.Attachment A: Do we only provided information as it pertains to our inpatient and emergency room services. For CHIPs proposals, as available from Inpatient unit.Attachment B: Does this apply to CHIPs ONLY applications? YES for inpatient unit as applicable.Attachment C: Which program code do we use for inpatient psychiatric services? Program Number is NOT APPLICABLE just use the Inpatient Psychiatric row to complete your information input into those cells.
Do we list services in ED if the ED will only be used as an entry point and assessment for inpatient admission. NOAttachment D: Do we only provided information as it pertains to our inpatient and emergency room services. For CHIPs proposals, as available from Inpatient unit
One additional question. What is the response turnaround time from DMH and will you be responding to individual questions via e-mail?
The Due Date for the electronic submission of your proposal has been changed to COB on Friday April 20, 2012 from the original close of business (COB) Monday, April 16, 2012.
Electronic submissions of your proposals should be sent to dhs.mh@illinois.gov by COB, Friday, April 20, 2012.
The exact written submission of your proposal must arrive as directed in the RFI by COB Monday, April 23, 2012 (allows for overnight mailing of submission made on April 20, 2012).Attachment A: Do we use the overall number of staff as the denominator in describing the specific staffing characterists?
"Staffing Characteristics" is a title line not for cell information or completion in the adjacent column.
Do the below two questions on Attachment A pertain to CHIPs portion or community health providers
The "language and ethnic group" information is helpful to assist DMH in assessing how the needs of consumers can be addressed.

Inquiry #2We do not have a behavioral health unit - nor do we currently have any services contracted through the Illinois DMH.
This document states Phase 1 will focus on engaging individuals presenting at community hospitals. It goes on to show the 5 new programs in green on page 9 - that the state department of mental health (DMH) hopes to promote through this RFI. CHIPS and BILT cannot apply to us because we do not have an existing behavioral health unit - which is one of the requirements. But the crisis outreach program could apply to us if we had qualified professionals in our ED - AND if we contract with DMH. My question is - do we have to complete this RFI by April 16 if we decide to do this? Can't we contract with DMH later?? (because we'll need time to find a qualified professional if that's the hospital's decision)… I read the prototype at Advocate Illinois Masonic ED (page 74) which was interesting. It mentions they receive DMH funding for their ED crisis team and for medication provided to the indigent patient. They do not have an inpatient behavioral health unit either. So - if we decided to replicate their model - could we seek funding through DMH after the April 16 RFI deadline?
Thanks for your time/help. We're trying to make sense out of this document as to how it could apply to us.

DMH RESPONSE:CHIPs and BILT: You are correct CHIPs would not be indicated for your hospital if you do not have existing licensed psychiatric beds (Acute Mental Illness category of service). BILT services, as in the Advocate model as well as at other hospitals, are often distinct sections of the hospital's ED in which persons with behavioral health crises are assessed and treated.
ED based Assessment / Linkage (page 9) could be alternative for which Adventist Bolingbrook Hospital could submit a proposal.
Crisis Outreach would likely be services, under contract to a community mental health provider, which would done in your ED to assist your ED staff with assessment and linkage activity.
We are expecting to contract with providers based on receipt of their interests and actual proposals including projected budget information. We would then negotiate with possible vendors regarding their submission. We would like to finalize negotiations and contracting by early May so as to allow contractors the opportunity to hire and train staff and provide, in some limited instances, treatment services but all for a transition on July 1st.
Advocate Northside (Illinois Masonic) does have an inpatient Psychiatric unit.
We do not expect to re-bid for these services beyond this RFI's deadline of April 20, 2012.

Inquiry #3Re the deadline……

Does the paper copy need to be mailed by the 16th (postmarked) or in your possession by the close of business?

DMH RESPONSE:The Due Date for the electronic submission of your proposal has been changed to COB on Friday April 20, 2012 from the original close of business (COB) Monday, April 16, 2012.
Electronic submissions of your proposals should be sent to dhs.mh@illinois.gov by COB, Friday, April 20, 2012.
The exact written submission of your proposal must arrive as directed in the RFI by COB Monday, April 23, 2012 (allows for overnight mailing of submission made on April 20, 2012).

DMH RESPONSE:Your actions in response to the RFI is only required should you wish to provide services to the target population as identified in the RFI.

Inquiry #5Mercy Hospital and Medical Center is interested in applying for CHIPS funding. Since the psychiatric staffing composition has changed from mostly attending to salaried psychiatrists, the obstacles that limited the use of CHIPS funding in the past no longer apply. Mercy Hospital routinely admits unfunded persons from our ED to the Inpatient Mental Health Unit. I have perused the e-mail and attachments pertaining to ATTP sent on 4-6-12, particularly Appendices 6 & 7 that refer to CHIPS.
I had a couple of questions:

Is the application for CHIPS only a narrative of the hospital's qualifications and capacity? It seemed that the Attachments that were part of the full ACCT application might not apply to CHIPS only application.

In Appendix 7, there is a listing of CHIPS and Non-CHIPS hospitals with information broken down into 4 categories. Can you help identify how Column 2 & 4 are calculated?

DMH RESPONSE:Is the application for CHIPS only a narrative of the hospital's qualifications and capacity? YES
It seemed that the Attachments that were part of the full ACCT application might not apply to CHIPS only application.
AS from similar question above Attachment A: Do we only provided information as it pertains to our inpatient and emergency room services. For CHIPs proposals, as available from Inpatient unit.
Attachment B: Does this apply to CHIPs ONLY applications? YES for inpatient unit as applicable.
Attachment C: Which program code do we use for inpatient psychiatric services? Program Number is NOT APPLICABLE just use the Inpatient Psychiatric row to complete your information input into those cells. Do we list services in ED if the ED will only be used as an entry point and assessment for inpatient admission. NO
Attachment D: Do we only provided information as it pertains to our inpatient and emergency room services. For CHIPs proposals, as available from Inpatient unit.
In Appendix 7, there is a listing of CHIPS and Non-CHIPS hospitals with information broken down into 4 categories. Can you help identify how Column 2 & 4 are calculated?
History FY 11 ED Admissions: This is official Tinley Park MHC information specific to the number of admissions during FY11 that came from that hospital.
CHIPS @ 60 % (What does this mean?) As stated in the RFI under Clinical Focus group section, a large percentage of cases admitted to TPMHC did not meet the standard of care for an inpatient admission. For our initial planning purposes, we have projected that @60% of admissions to TPMHC from these hospital EDs would still need an inpatient admission and therefore used this as a projected CHIPs admission total.
Projected Inpatient Days This equals - Projected CHIPs Admissions times a 6 day average length of stay (ALOS).
Projected ADC (What does this mean?) Using the projection of days this would be the average daily census of cases under the CHIPs contract at or for that hospital.

Inquiry #6I received your RFI documents and attachments last week. MacNeal hospital is interested in purchasing CHIPS services. In referring to the attachments, can you help clarify which attachments (A, B, C, or D) and/or sections of attachments would apply to purchasing CHIPS beds for an existing hospital with inpatient psychiatric units?

DMH RESPONSE:
As from a similar question above
Attachment A: Do we only provided information as it pertains to our inpatient and emergency room services. For CHIPs proposals, as available from Inpatient unit
Attachment B: Does this apply to CHIPs ONLY applications? YES for inpatient unit as applicable
Attachment C: Which program code do we use for inpatient psychiatric services? Program Number is NOT APPLICABLE just use the Inpatient Psychiatric row to complete your information input into those cells.
Do we list services in ED if the ED will only be used as an entry point and assessment for inpatient admission. NO
Attachment D: Do we only provided information as it pertains to our inpatient and emergency room services. For CHIPs proposals, as available from Inpatient unit

April 10, 2012

Inquiry #1
What is the expected response to questions turnaround time and will we hear from you via e-mail or the response to questions site at http://www.dhs.state.il.us/page.aspx?item=60137 ?
Attachment C question: If we are only applying for the CHIPs portion do we qualify for psychiatric leadership, psychiatric medications, or quality administrator funding. #1a) And, when I click on the link sent by IdentityManagement@illinois.gov after I registered I get the following message. The page cannot be displayed
Explanation: There is a problem with the page you are trying to reach and it cannot be displayed.
Try the following:
Refresh page: Search for the page again by clicking the Refresh button. The timeout may have occurred due to Internet congestion.
Check spelling: Check that you typed the Web page address correctly. The address may have been mistyped.
Access from a link: If there is a link to the page you are looking for, try accessing the page from that link.
Technical Information (for support personnel)
* Error Code: 403 Forbidden. The server denied the specified Uniform Resource Locator (URL). Contact the server administrator. (12202)

Inquiry #2I am an LCSW at Morris Hospital currently assisting with the response to the IDHS request for Information. Morris Hospital is one of the 6 community hospital with no behavioral health services in place. We want to respond to the RFI but need to to clarify a few questions as quickly as possible in order to do so.

Does the term "Qualified Responders", as used in Section III. Services to Be Purchased Under This RFI, page 10, 11, 12, refer to those facilities and organizations that are eligible to apply for ED-Based Assessment, CHIPS, & BILT, as provided in the RFI proposal because they already have behavioral health in place?Answer: ED based Assessment / Linkage (page 9) could be alternative for which Morris Hospital could submit a proposal.

What portion, if any, of the attachments are applicable to the 6 community hospitals with no BH? In reading the document, my understanding is that our only option for services during Phase I is the ACARES program because we do not have any ED or inpatient behavioral health services in place.Answer: ED based Assessment / Linkage (page 9) could be alternative for which Morris Hospital could submit a proposal. All attachments would be required.
ACARES is not a "treatment service provider" but a system contractor that will provide eligibility / enrollment administrative functions.
Crisis Outreach would likely be services, under contract to a community mental health provider, which would come to your ED to assist your ED staff with assessment and linkage activity.

Does the deadline of April 16th mean that the hard copy has to be post marked by the end of business day on the 16th and the electronic copy emailed by the 16th? That is my understanding.Answer:The Due Date for the electronic submission of your proposal has been changed to COB on Friday April 20, 2012 from the original close of business (COB) Monday, April 16, 2012.
Electronic submissions of your proposals should be sent to dhs.mh@illinois.gov by COB, Friday, April 20, 2012.
The exact written submission of your proposal must arrive as directed in the RFI by COB Monday, April 23, 2012 (allows for overnight mailing of submission made on April 20, 2012).

Is there a possibility that DHS will give an extension to this deadline due to the Easter week release of the RFI?Answer: SEE above

If MH wants to join a hospital that does have behavioral health like St Joe's or Silver Cross for CHIP beds, do we need to have an MOU or letter of intent with that facility or is that not necessary as we will have an ACARES worker coming to assess the unfunded patients and finding placement if needed?Answer: AS stated on page 72 "DMH is wishing to contract with hospitals with existing inpatient BH units for utilization numbers both from their ED but also to support portions of the other capacity from other area hospital EDs where no inpatient BH capacity exists." Morris Hospital referrals would be part of DMH negotiations with CHIPs contractors.

Page 11 of the RFI refers to Appendix 7 -CHIPS Projections. Morris Hospital is not on the Appendix. I believe Stoger was inadvertently listed rather than Morris.Answer: You are correct Morris Hospital referral information was omitted from Appendix 7. The Morris Hospital volume figures should be: 33 historical FY11 admissions; 20 projected admissions, multiplied by 6 (ALOS) would equal 120 inpatient days for and ADC demand of 0.33 patients per day.

Also on page 11, the last sentence of same paragraph states that "...more specific targeted volumes will be let based upon submission of proposals..." Would you clarify what is meant by "let- based?" Answer: DMH has projected CHIPS volumes in Appendix 7. Upon receipt of CHIPs proposals and during negotiations DMH will let (agree to) contracts that have more specific and distinct anticipated CHIPs volumes at each contracted hospital.

Our interpretation of the Transportation section under NOTE: (pg 17) referencing Grundy Co is that DHS will provide transportation for voluntary patients needing SUD treatment/DASA services. Is this correct?Answer: Transportation for voluntary patients to alternative MH SUD services is part of the services under consideration as a DMH contracting responsibility. Providers, either DMH or DASA, that have existing transportation capability can include that function in their proposal, i.e. picking up a referred person at the ED and transporting the to their treatment site. Without such providers proposals DMH would purchase transportation separately.

Would DHS consider contracting with a private practice psychiatry group in the community that is certified to provide behavioral Medicaid Services and Dasa Certified for Crisis Outreach, and for DMH Enhanced Community Services? If so, is that something that would need to be requested in this RFI? Or would that be a Phase 2 or later implementation?Answer: DMH would consider contracting with Psychiatric group for "Access to Psychiatry" services. Only those providers currently contracted for DMH Rule 132 services are eligible to provide Crisis Outreach or enhanced Rule 132 services.

Morris Hospital is also a part of Region 2. Is there any projected date on Singer closing and does DHS plan to use a similar RFI for that service area?Answer: For DMH purposes Morris Hospital and Grundy County in total are part of Region 1 South alone. Singer date is targeted for October 231, 2012. A similar planning process has started for the Singer Rebalancing.

DMH RESPONSE:Any admissions to any hospital under the CHIPs program would be part of normal routine business of that hospital. The requirement for a Medicaid application does anticipate that a significant percentage of CHIPs admissions would convert to Public Aid coverage. How this might impact the hospital's Medicaid utilization rate (%) would be a factor that each hospital should consider independently.

April 11, 2012

Inquiries #1I am able to access the "response to inquiries" site without difficulty but have not seen a response to the questions below. At this point I cannot continue with the application until I have response to the questions previously asked.

Inquiries #2I would like to submit the following questions on behalf of Cornell Interventions, Inc. (operating at Southwood Interventions) to be addressed on tomorrow's Q&A call.
Are providers expected to utilize current funding sources (DASA and Medicaid) to fund the services? #2
I would like to submit the following questions on behalf of Cornell Interventions, Inc. (operating at Southwood Interventions) to be addressed on tomorrow's Q&A call.

Are providers expected to utilize current funding sources (DASA and Medicaid) to fund the services?

How are providers to determine the cost of medication if the expectation is that providers will offer this service since it varies from person to person? Is there statistical information available based on the current population?Answer: Discharge diagnosis is available in the Appendix Four

Under DASA Enhanced Community Services, we are able to offer #1-Outpatient Services, but do not provide 2 and 3. Is it possible to offer Outpatient Services without Medication and Medication Assisted Treatment and Recovery Coaches/Mentors or is IDHS only looking for provider to offer all 3?Answer: Potentials vendors can submit proposals for only 3.5 or 3.7 services or for whatever levels of care (services) for which they hold a certification / license with DASA as it is related to the objectives of the RFI.

How will the stipend for transition medications work?Answer: Providers are asked to project their discharge medication cost for this population. Providers will receive a stipend amount -proportional amount of the total - of which they hold and can access for emergency prescriptions and dispensing. The larger amount would be funds available through the DHS pharmacy services for draw down (against) that would provide for mail order dispensing of discharge medications.

Is a narrative required as a supplement to the attachments or is it sufficient for provider to only complete Attachments A through D?Answer: A brief narrative submitted with your attachments would be accepted
Will notes be sent out following the conference call tomorrow with responses to questions?Answer: Transcription of the technical assistance call should be available within 2 business days and will be posted on the Responses and Inquiries (http://www.dhs.state.il.us/page.aspx?item=60137)